Kaufman M J, Pollack M H, Villafuerte R A, Kukes T J, Rose S L, Mendelson J H, Cohen B M, Renshaw P F
Brain Imaging Center, McLean Hospital, MA 02478, USA.
Psychiatry Res. 1999 Jun 30;90(3):143-52. doi: 10.1016/s0925-4927(99)00017-7.
This study evaluated cerebral phosphorus metabolites in opiate-dependent polydrug abusers in methadone maintenance therapy (MMT) and determined whether metabolite profiles differed based on treatment duration. Phosphorus magnetic resonance spectroscopy (31P-MRS) data were acquired with the ISIS volume localization method from a 50-mm thick axial brain slice through the orbitofrontal and occipital cortices. Study subjects included 15 MMT subjects, seven having undergone treatment for an average of 39 +/- 23 weeks (mean +/- S.D.) and eight having undergone treatment for 137 +/- 53 weeks, as well as an age matched comparison group (n = 16). The methadone dose administered on the study day averaged 70.5 +/- 17.1 mg and was statistically equivalent in short- and long-term subgroups. MMT subjects (n = 15) differed from control subjects in percent phosphocreatine (%PCr) levels (-13%), and in both phosphomonoester (%PME, +13%) and phosphodiester (%PDE, +10%) levels, which likely reflect abnormalities in energy and phospholipid metabolism, respectively. There were no sex effects or group by sex interaction effects on these measures. In short-term MMT treatment subjects, abnormal %PCr (-18%), %PME (+20%) and %PDE (+17%) levels were found compared with control subjects. The only metabolite abnormality detected in long-term MMT subjects was decreased %PCr (-9%), in spite of continued illicit drug abuse. From these data, we conclude that polydrug abusers in MMT have 31P-MRS results consistent with abnormal brain metabolism and phospholipid balance. The nearly normal metabolite profile in long-term MMT subjects suggests that prolonged MMT may be associated with improved neurochemistry.
本研究评估了接受美沙酮维持治疗（MMT）的阿片类药物依赖多药滥用者的脑磷代谢物，并确定代谢物谱是否因治疗持续时间而异。采用ISIS容积定位法，从穿过眶额皮质和枕叶皮质的50毫米厚轴向脑切片获取磷磁共振波谱（31P-MRS）数据。研究对象包括15名接受MMT治疗的受试者，其中7人平均接受治疗39±23周（均值±标准差），8人接受治疗137±53周，以及一个年龄匹配的对照组（n = 16）。研究当天给予的美沙酮剂量平均为70.5±17.1毫克，在短期和长期亚组中具有统计学等效性。MMT受试者（n = 15）与对照受试者在磷酸肌酸（%PCr）水平（-13%）、磷酸单酯（%PME，+13%）和磷酸二酯（%PDE，+10%）水平上存在差异，这可能分别反映了能量和磷脂代谢的异常。这些指标不存在性别效应或性别与组别的交互效应。与对照受试者相比，短期MMT治疗受试者的%PCr（-18%）、%PME（+20%）和%PDE（+17%）水平异常。尽管长期MMT受试者持续存在非法药物滥用，但在他们身上检测到的唯一代谢物异常是%PCr降低（-9%）。根据这些数据，我们得出结论，MMT中的多药滥用者的31P-MRS结果与脑代谢异常和磷脂平衡一致。长期MMT受试者几乎正常的代谢物谱表明，延长MMT可能与神经化学改善有关。
